Pealkiri: 

Enhanced tuberculosis case detection among substitution treatment patients: a randomized controlled trial

Autorid: Rüütel K , Loit HM , Sepp T , Kliiman K , McNutt LA , Uusküla A
Väljaandja/tellija: BMC Res Notes
Märksõnad: tuberkuloos, narkomaania, terviseteenused, patsiendid, ravi
Välja antud: 2011
Viide: Rüütel K, Loit HM, Sepp T, et al. Enhanced tuberculosis case detection among substitution treatment patients: a randomized controlled trial. BMC Res Notes 2011;4:192.
Link: http://www.biomedcentral.com/1756-0500/4/192/abstract
Alamvaldkonnad:Nakkushaigused
Kirjeldus: Background
Historically, HIV, TB (tuberculosis) and illegal drug treatment services in Estonia have been developed as vertical structures. Related health care services are often provided by different health care institutions and in different locations. This may present obstacles for vulnerable groups, such as injecting drug users (IDU), to access the needed services. We conducted a small scale randomized controlled trial to evaluate a case management intervention aimed at increasing TB screening and treatment entry among IDUs referred from a methadone drug treatment program in Jõhvi, North-Eastern Estonia.

Findings
Of the 189 potential subjects, 112 (59%) participated. HIV prevalence was 86% (n = 96) and 7.4% (n = 8) of participants were interferon gamma release assay (IGRA) positive (6.5% were both HIV and IGRA-positive, n = 7). Overall, 44% of participants (n = 49) attended TB clinic, 17 (30%) from control group and 32 (57%) from case management group (p = 0.004). None of the participants were diagnosed with TB. In a multivariate model, those randomized to case management group were more likely to access TB screening services.

Conclusions
These findings demonstrate the urgent need for scaling up TB screening among IDUs and the value of more active approach in referring substitution treatment patients to TB services.